Chronic renal failure

Chronic renal failure
Chronic Poisoning
CRF; Chronic renal insufficiency; Chronic kidney disease, unspecified
Some of the common nonoccupational chronic renal diseases are diabetic renal disease, hypertensive renal disease, polycystic kidney disease, analgesic nephropathy, hemolytic uremic syndrome, and renal disease associated with infections and illicit drugs (HIV, hepatitis B and C). Acute renal failure (ARF) often occurs in the context of multiorgan failure. Community-acquired ARF is not very common, and it usually has a good prognosis. [Wallace, p. 1089-94] The chemical agents linked to work-related chronic renal disease are the three metals mercury, lead, and cadmium. [LaDou, Rosenstock, Sullivan, Levy] Mercury poisoning is one of the uncommon causes of nephrotic syndrome. [Goldfrank, p. 388] "The two forms of renal disease resulting from mercury exposure are acute tubular necrosis and nephrotic syndrome." [LaDou, p. 422] Heavy, prolonged occupational exposures to lead and cadmium can cause chronic tubulointerstitial nephropathy. Such exposures occurred in the past when workers produced lead and cadmium products and there were no occupational exposure limits. "Historic cohort mortality studies of cadmium-exposed working populations have yielded mixed results in studying end-stage renal disease as a cause of death." [Rosenstock, p. 579] "Evidence from chronic lead nephropathy is not consistent. In some reports, workers with previous heavy and long-term lead exposure display little, if any, evidence of adverse renal effects." [APHA, p. 437] "Although high lead concentrations in blood have long been linked to kidney damage and chronic kidney disease (CKD), possible effects of long-term exposure at blood lead level less than 800 ug/L [80 ug/dL] are less well substantiated." [ACGIH: BEI Documentation] "Increased activities of U-NAG [a biomarker of kidney injury] during ongoing exposure to mercury vapor appear to be reversible upon cessation of exposure." [PMID 16804628]
Years to decades;
Serum creatinine may be within normal limits until almost 50% of nephron function is lost. [APHA, p. 435] Proteinuria > 150 mg/day; Albumin: marker of glomerular dysfunction; B-2-microglobulin: marker of tubular dysfunction; [Rosenstock, p. 567]
ICD-9 Code
ICD-10 Code

Symptoms/Findings, Job Tasks, and Agents Linked to This Disease


Hazardous agents that cause the occupational disease: